Transesophageal Echocardiography As a Monitoring Tool During Transvenous Lead Extraction-Does It Improve Procedure Effectiveness?

Overview

Journal J Clin Med

Specialty General Medicine

Date 2020 May 14

PMID 32397115

Citations 17

Authors

Dorota Nowosielecka

Wojciech Jachec

Anna Polewczyk

Lukasz Tulecki

Konrad Tomkow

Pawel Stefanczyk

Andrzej Tomaszewski

Wojciech Brzozowski

Dorota Szczesniak-Stanczyk

Andrzej Kleinrok

Andrzej Kutarski

Affiliations

Soon will be listed here.

Abstract

Background: Transesophageal echocardiography (TEE) is a valuable tool for monitoring the patient during transvenous lead extraction (TLE), but the direct impact of TEE on the effectiveness and safety of TLE has not yet been documented.

Methods: The effectiveness of TLE and short-term survival were compared between two groups of patients: 2106 patients in whom TEE was performed before and after TLE and 1079 individuals in whom continuous TEE monitoring was used. The procedure-related risk of major complications was assessed using a predictive SAFeTY TLE score.

Results: The patients monitored by TEE were characterized by older age, more comorbidities and higher SAFeTY TLE scores (6.143 ± 4.395 vs. 5.593 ± 4.127; p = 0.004). Complete procedural success was significantly higher in the TEE-guided group (97.683% vs. 95.442%, < 0.01). The rate of serious complications in the TEE-guided group was lower than the predictive SAFeTY TLE score-a reduction of 28.75% ( < 0.05). Periprocedural mortality in the TEE-guided and non-TEE-guided groups was zero vs. six deaths ( = 0.186). Short-term survival was comparable between the groups.

Conclusions: Transesophageal echocardiography as a monitoring tool during transvenous lead extraction provides valuable results-higher rates of complete procedural success and a reduced risk of the most severe complications, thus preventing periprocedural deaths.

Citing Articles

What Important Information Does Transesophageal Echocardiography Provide When Performed before Transvenous Lead Extraction?.

Nowosielecka D, Jachec W, Stefanczyk Dzida M, Polewczyk A, Moscicka D, Nowosielecka A J Clin Med. 2024; 13(17).

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Shared Decision Making and Cardioneuroablation Allow Discontinuation of Permanent Pacing in Patients with Vagally Mediated Bradycardia.

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Incomplete Lead Removal During the Extraction Procedure: Predisposing Factors and Impact on Long-Term Survival in Infectious and Non-Infectious Cases: Analysis of 3741 Procedures.

Kutarski A, Jachec W, Polewczyk A, Nowosielecka D J Clin Med. 2023; 12(8).

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Practical Approaches to Transvenous Lead Extraction Procedures-Clinical Case Series.

Boarescu P, Popa I, Trifan C, Rosian A, Rosian S Int J Environ Res Public Health. 2023; 20(1).

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Efficacy and Safety of Transvenous Lead Extraction at the Time of Upgrade from Pacemakers to Cardioverter-Defibrillators and Cardiac Resynchronization Therapy.

Stefanczyk P, Nowosielecka D, Polewczyk A, Jachec W, Glowniak A, Kosior J Int J Environ Res Public Health. 2023; 20(1).

PMID: 36612613 PMC: 9819767. DOI: 10.3390/ijerph20010291.

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